Individual provider Active NPI

Bryan T Hotujec, M.D.

  • Obstetrics & Gynecology Physician
  • Coon Rapids, MN
National Provider Identifier
1215167051
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
55026-020 Issued in WI
Practice address
3960 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2569
Phone
(763) 236-9236
Fax
(763) 684-6006
NPI assigned
Jul 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 55026-020 WI Primary

Addresses

Primary practice location

3960 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2569

Mailing address

3960 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2569
Phone (763) 236-9236

Other identifiers 1

IdentifierTypeStateIssuer
61439OtherWIDEAN HEALTH INSURANCE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bhotujec469692@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200311001162 MN Practitioner - Obstetrics/Gynecology 1456585926 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Wisconsin School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55026-020WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Apr 13, 2020 Accepting new patients
Allina Health System CurrentSince Apr 13, 2020 Accepting new patients
Allina Health System Obstetrics & Gynecology Current Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System Past Accepting new patients
Allina Health System Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

303 Catlin St
Buffalo, MN 55313
Phone (763) 682-1212

3960 Coon Rapids Blvd NW
Ste 200
Coon Rapids, MN 55433
Phone (763) 236-9236

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

3960 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-7337

2805 Dodd Rd
Ste 100
Saint Paul, MN 55121
Phone (651) 241-7733

4194 Lexington Ave N
Shoreview, MN 55126
Phone (651) 483-5461

Interoperability endpoints

  • Direct secure messaging: bhotujec469692@excellian.direct.allina.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1215167051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332569",
            "telephone_number": "763-236-9236",
            "fax_number": "763-236-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332569",
            "telephone_number": "763-236-9236",
            "fax_number": "763-684-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOTUJEC",
        "first_name": "BRYAN",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "55026-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "61439",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bhotujec469692@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "3960 Coon Rapids Blvd NW",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554332569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.